{"id":5658,"date":"2019-10-09T11:42:23","date_gmt":"2019-10-09T10:42:23","guid":{"rendered":"http:\/\/www.library.sath.nhs.uk\/research\/?p=5658"},"modified":"2021-03-22T09:57:54","modified_gmt":"2021-03-22T09:57:54","slug":"best-supportive-care-bsc-with-or-without-lowdose-chemotherapy-chemo-in-frail-elderly-patients-with-advanced-gastroesophageal-cancer-agoac-the-uncertain-randomization-of-the-go2-phase-iii-trial","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2019\/10\/09\/best-supportive-care-bsc-with-or-without-lowdose-chemotherapy-chemo-in-frail-elderly-patients-with-advanced-gastroesophageal-cancer-agoac-the-uncertain-randomization-of-the-go2-phase-iii-trial\/","title":{"rendered":"Best supportive care (BSC) with or without lowdose chemotherapy (chemo) in frail elderly patients with advanced gastroesophageal cancer (aGOAC): The uncertain randomization of the GO2 phase III trial (2019)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\nSwinson D.; Hingorani M.; Stokes Z.; Dent J.; Guptal K.; *Chatterjee A.; Kamposioras K.; Grumett S.A.; Khan M.; Marshall H.; Ruddock S.; Allmark C.; Katona E.; Howard H.C.; Velikova G.; Lord S.; Hall P.S.; Seymour M.T.<\/p>\n

Citation:<\/strong>
\nJournal of Clinical Oncology; May 2019; vol. 37<\/p>\n

Abstract:<\/strong>
\nBackground: Before 2000, trials comparing BSC +\/chemo for aGOAC showed overall survival (OS) benefit, but in predominantly fit patients (pts). We have revisited this question in a modern context, using lowdose chemo in a frail population, with comprehensive baseline health and frailty assessment.
\nMethod(s): In the GO2 trial, elderly and\/or frail aGOAC pts with a ?certain? indication for chemo were randomised between 3 chemo doses. In this GO2 sub-study, pts with an ?uncertain? indication for chemo were instead randomised to BSC +\/- the lowest dose chemo. Pts were eligible if clinician and pt agreed the indication for chemo was uncertain. There was no PS threshold, but eGFR >=30 and bili < 2xULN were required. Baseline assessment included global QL, symptom & functional scales, frailty and comorbidity. Randomisation was 1:1 to BSC alone, or with oxaliplatin 78 mg\/m2 d1, capecitabine 375 mg\/m2 bd d121 (modified if eGFR 3050 ml\/min or bili 1.52.0 xULN), q21d. QL was reassessed after 9 and 18 wks. The primary endpoint analysis was OS, adjusted for baseline factors. The sample size for this exploratory sub-study was not preset, but around 60 pts were anticipated.
\nResult(s): 558 pts entered GO2 at 61 centres 201417, of whom only 45 pts (8%) at 21 centres entered this uncertain randomisation. This would provide 80% power at p = 0.05 (2tailed) to detect an OS HR of 0.3. OS was shorter in pts with worse baseline PS (p<0.01) or distant mets (p<0.05). OS was not significantly improved with chemo; however we cannot exclude HR >0.32. QL deteriorated less with BSC+chemo than with BSC alone.
\nConclusion(s): In this frail, poor PS population, we observed a small survival benefit with chemo but this did not reach statistical significance. Clinicians should carefully consider BSC alone as a valid treatment option for aGOAC pts with poor PS and\/or frailty.<\/p>\n

Link to full-text<\/a> [no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Swinson D.; Hingorani M.; Stokes Z.; Dent J.; Guptal K.; *Chatterjee A.; Kamposioras K.; Grumett S.A.; Khan M.; Marshall H.; Ruddock S.; Allmark C.; Katona E.; Howard H.C.; Velikova G.; Lord S.; Hall P.S.;…<\/span><\/p>\n

Read more Best supportive care (BSC) with or without lowdose chemotherapy (chemo) in frail elderly patients with advanced gastroesophageal cancer (aGOAC): The uncertain randomization of the GO2 phase III trial (2019)<\/span> ›<\/span><\/a><\/div>\n

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